Anger and concern persist over Brampton hospital situation
By Bill Rea

Jagtar Shergill, co-chair of the Brampton Health Coalition moderated last Thursday's meeting.

The hospital situation in Brampton is still a concern to many in the community, and those people are drawing powerful support.

More than 100 of them attended a meeting last Thursday night, hosted by the Brampton Health Coalition, to hear people vent about the situation and to do some venting themselves.

The concerns deal with the new Brampton Civic Hospital, which was created as a public private partnership (P3), much to the displeasure of many, including the Ontario Health Coalition and its Brampton chapter. And there were many comments about the status of the old Peel memorial Hospital site, with calls for it to be restored as a fully functional hospital.

Those offering their support last week included federal NDP Leader Jack Layton, who delivered a phone message that was broadcast throughout the hall.

"I wish I could be there with you," he stated, adding there have been a number of cases of privatization of services all over the country.

Peterborough Health Coalition co-chair Roy Brady, Toronto Danforth MPP Peter Tabuns, Ottawa Health Coalition co-chair Marlene Rivier, and Brampton - Springdale MP Dr. Ruby Dhalla.

He also lashed out at what he called "for-profit medicare in Canada," charging it takes money from direct health care.

"We're headed toward an American system, which is going to leave people behind," Layton remarked, adding the traditional Canadian system "reflects our values of caring for one another."

The provincial NDP was represented by Toronto Danforth MPP Peter Tabuns, who used to be the party's critic for public infrastructure renewal.

He voiced opposition for P3. "We felt it was bad news for health care," he declared, adding if there's going to be a system that really answers needs, it has to be public.

Brampton - Springdale (Liberal) MP Dr. Ruby Dhalla, stated people deserve the highest quality of hospital care. She also said a lot of this relates to the provincial government, but added it's not about political jurisdictions.

Brmpton Board of Trade President-elect Carman McClelland also addressed the meeting.

"It's about getting the job done," she declared. "I will work with you and stand with you to ensure we get the job done."

One man in the audience called on Dhalla to get Liberal Leader Stephane Dion to defeat the minority federal government as soon as possible, in order to get federal Health Minister Tony Clement defeated.

Ontario Health Coalition Director Natalie Mehra said there have been a number of public meetings to discuss these issues, including some recent ones organized by the Central West Local Health Integration Network (LHIN). while these sessions were positive, Mehra said they didn't accomplish what they set out to do, which was pull all the parties together. She also charged local politicians have not been attending these meetings (Brampton City Councillor Vicki Dhillon was at last week's session). She added they sent letters to the local MPPs, assuring them they not trying to copy the work of the LHINs, which she said are run by political appointees who serve at the pleasure of the provincial cabinet. She stressed they wanted to hear from people who are accountable to the public. But most of the politicians have been turning down invitations to attend meetings, she said, although some have apologized "profusely."

"They are earning our tax dollars," one woman shouted from the audience. "The LHINs are not our elected representatives."

Lawyer Steven Shrybman commented on some of the dealings that went into setting up the new hospital.

He said it used to be a case that public hospitals were built with public funds and were run by community boards that were accountable to the Minister of Health. It was the former provincial government under Mike Harris that decided to try and privatize health and some other public services; "as many as he could get away with."

The Harris government set up P3s without any public debate, and Shrybman said they had to go to court to learn about terms and provisions of the deal. What they found was "horrendous" for people, he declared.

A private, for-profit consortium was contracted to build, finance and operate the hospital, and Shrybman stated it will be taking dividends out of the operation, adding they won't be paying tax on that money. As well, he said the province wrote a cheque for $20 million to help cover the consortium's costs. The result, he said is "you got half the hospital for twice the price."

Shrybman also said hospital CEOs have been consulted, and there's general agreement that such a P3 facility would be unmanageable. He added hospitals are notoriously hard to manage anyway. These CEOs have stated hospitals need a strong, team-oriented approach when it comes to day-to-day management, and they don't think that's possible when doctors and nurses report to a non-profit organization, while the people supplying the services report to a consortium.

Under the 25-year arrangement, Shrybman said the consortium builds the hospital and then leases it back, while having a 25-year contract for providing the support services.

He also observed the arrangements are complicated. "It's a lovely instrument for lawyers," he remarked.

Hospitals generally contract out things like food or laundry services, but Shrybman said they are simple, and can be cancelled if the company getting the contract doesn't deliver. Under the P3 system, he said if the board is not happy with a service, it can't get out of the deal without collapsing the entire scheme.

"It's just a disaster in terms of a management model for a hospital," he declared.

Shrybman also said there are penalties against the consortium if some action on its part kills a patient. The penalty is in terms of a deduction in the dividends it receives. "But they don't tell you how to fix the problem," he declared.

This new hospital will be a very destructive device when it comes to taking down public health care, he warned.

Shrybman added the consortium can sell anything in the facility, with the exception of alcohol, tobacco or sex. That means it can allow private clinics offering enhanced services. He said that means the quality of care one receives could depend on their credit card, rather than their health card.

"The model is a phenomenal betrayal of the public interest," he declared.

Marlene Rivier, co-chair of the Ottawa Health Coalition, had some horror stories to offer on what went on with the P3 facility there.

"There's an awful lot to tell you," she remarked, pointing out the original plan was to build a 284-bed Royal Ottawa Hospital for $95 million, but what they got was 188 beds for $146 million.

Rivier also pointed out the hospital opened six weeks ahead of schedule, but that wasn't much to brag about. The money doesn't start flowing to the private partners until the facility is occupied, so the medical staff was working shoulderto shoulder with people wearing hard hats. There were also no working phones or computers in the hospital when it opened 15 months ago. "The system is still not stable," she said.

As well, Rivier said there's a lot of secrecy about the P3 arrangements, as not one document has been released yet.

She also commented there have been a lot of errors with the food service at the hospital, where according to a survey, half of the special diet meals are not being delivered correctly.

Rivier said a colleague of hers had received a written reprimand for trying so sort out some of these problems.

She added there have been secondary situations created by the P3 arrangement. In order to save money, she said the housekeeping staff has been cut back in evenings, and eliminated at night. That has led to the implementation of a policy known as "you find it, you clean it," with some staff being forced to handle things they're not trained to deal with, such handling materials that might be HIV infected.

But Roy Brady, co-chair of the Peterborough Health Coalition, had some positive things to report on what's been going on there. They are slated to have a new hospital open this year, it won't be P3 arrangement, it's on budget and on time.

Brady said it took a lot of lobbying, community work and demands for accountability to bring this about.

Things didn't go completely as planned. The construction tenders came in over budget, so the project had to be cut back, from 529 beds to about 489.

"We are really looking forward to our new hospital," he declared.

The Brampton Board of Trade is also involved in this fight.

Carman McClelland, president-elect of the board, addressed issues involving the Peel Memorial Hospital site, stating they have taken five positions regarding that; the site is to be developed or redeveloped into a fullservice hospital; it has to be done as quickly as possible; there needs to be creative and innovative ideas in the area of funding and service delivery; that the economic viability of the area depends on this site; and that the Brampton Civic facility has to be running at capacity first, but not at the expense of the Peel Memorial operation.

Mehra said the new hospital has been the victim of some $300 million in cost overruns, adding is smaller than what was first promised. She cited a report from the Ontario Health Coalition, dated last month, stating when the ground was broken in 2002, they were looking at a cost of $350 million for a 608-bed facility (plus 112 beds at the redeveloped Peel Memorial site). By November 2003, the cost was up to $430 million, and by March '04, it was $536 million, with no mention of the Peel Memorial beds. the report also stated a project agreement was released at that time, with "substantial portions blocked out."

By May 2007, the cost was at $650 million.

Mehra stated the people of the area have been treat like guinea pigs, adding they never asked to have this experiment performed on them.

People at the meeting were advised to lobby the local MPPs for action

Dufferin - Caledon MPP Sylvia Jones wasn't at the meeting, but she later pointed out the Central West LHIN has the lowest percapita funding in the province. "The government hasn't responded to that," she said.